DAY- I IMAGES OF NURSES IN MEDIA- MYTHS AND REALITIES

PREPARED BY, DR. REETHADEVI. V. S VICE PRINCIPAL GOVT. COLLEGE OF NURSING KOZHIKODE

INTRODUCTION:
Image may appear to be an unusual topic for a nursing textbook, but it is not. Image is a part of a profession. It is the way a person appears to others, or in case of a profession, the way that profession appears to other disciplines and to the general public consumers of health care. Image and perception of the profession impact recruitment of students, the view of the public, finding for nursing education and research, relationships with healthcare administrators and other health care professionals, government agencies and legislators at all levels of government, and ultimately, the professions self-identity. Just like individuals may feel depressed or less effective if others view them negatively, professionals can experience similar reactions if their image is not positive. It impacts everything the profession does or wishes to do. Image is a part of any profession. How nurses view themselves- their professional self-image-has an impact on professional self-esteem. How one is viewed has an impact on whether others seek that person out and how they view the effectiveness of what that person might do. Every time a nurse says to the family, friends, or in public that he or she is a nurse, the nurse is representing profession. This has an impact on the image of nursing. Buresh and Gordon stated, we cannot expect outsiders to be the guardians of our visibility and access to public media and health policy arenas. We must develop the skills of presenting ourselves in the media and to the media-we have to take the responsibility for moving from silence to voice (Buresh and Gordon,200,as cited in Benner,2005,p.15)

NEED FOR DISCUSSION ABOUT NURSES IMAGE:

Nurses are often invisible in national crisis Unrecognized role in safeguarding health Nurses have not yet received much media coverage

VISIBILITY: GOOD OR BAD?

Although nurses comprise the majority of healthcare professionals, they are largely invisible. Their competence, skill, knowledge, and judgment are- as the word image suggests- only a reflection, not reality (Sullivan,2004,p.45). the public views of nursing and nurses are typically based on personal experiences with nurses, which can lead to a narrow view of a nurse often based only on a brief personal experience. This experience may not provide an accurate picture of all that nurses can do provide in the health care delivery process, in addition, this view is influenced by the emotional response of a person to the situation and the encounter with a nurse. But the truth is that most often, the nurse is invisible. Consumers may not recognize that they are interacting with a nurse, or they may think someone is a nurse who is not.

CAUSES FOR INVISIBILITY:

The nurses voice is typically silent, and this has demoralized nursing

Historical role of nurse as handmaiden Hierarchical structure of healthcare organizations. Perceived authority and directives of physicians Threat of disciplinary or legal action or loss of job

INTERNAL FACTORS AFFECTING IMAGE OF NURSES:

role confusion lack of professional confidence timidity fear insecurity sense of inferiority

CURRENT IMAGE OF NURSING AND HOW IT IS IMPACTED BY PAST IMAGES?

The role of nursing has experienced many changes, and many more will occur. How has nursing responded to these changes and communicated them to the public and other health care professionals? Suzanne Gordon , a journalist who has written a lot about the nursing profession, noted that often it is the media that is accused of representing nursing poorly, when in reality, the media is reflecting the public image of nursing (Buresh and Gordon, 2006). Nurses have not taken the lead in standing up and discussing their own image of nursing- what it is and what it is not. It is not uncommon for a nurse to refuse to talk to the press because the nurse feels no need to do this or sometimes because of the fear of reprisal from the nurses employer.

HOW DO NURSES VIEW THEMSELVES?

Nurse did not have a consensus opinion about what might improve the image of nursing.

MEDIAS..ON THE GAME..

Since the mid 19770s, there has been a burgeoning interest in the study of popular images of nurses and nursing, and it seems that every conceivable aspect of those images has been scrutinized. Writers have focused on images of nurse and nursing on television, in cinema, in novels and short stories, in news coverage, and elsewhere. This fascination with the image of nurses is interesting. With the possible exception of doctors, there is no comparable body of inquiry regarding the image of teachers, social workers, physiotherapists, accountants, occupational therapists or other professional groups. Since most examinations of nursings image have been produced by nurses and have been largely promoted within nursing itself, this may demonstrate the professions discomfort with persistently stereotyped images of nurses work stereotypes that continue to shape public expectations of nurses and public decisions about the allocation of societal resources to nursing. The unfortunate fact is that public beliefs of the

importance of nursing are shaped by the images people see-as patients, family members, members of a community, and consumers of the media- from the journalistic to the entertainment.

WHATS THE BIG DEAL?

The global medias relentless linking of sexual images to the profession of nursing reinforces longstanding stereotypes. Even though those images are often jokes or fantasies, the stereotypes they promote discourage practicing and potential nurses, foster sexual violence in the work place, and contribute to a general atmosphere of disrespect. Even humor and fantasy images affect how people act. That is why advertisers spend billions on them. Desexualizing the nursing image is a key part of building the strength the profession needs to overcome the current shortage, which is taking lives worldwide, and to meet the challenges of modern health care.( The Center for Nursing Advocacy, 2007)

NURSINGS EARLY ICONOGRAPHY:

Representations and images of nursing are as old as nursing and healing themselves. By tracing the origins of modern nursing back to antiquity and to the earliest accounts of babies, pregnant woman, family, and other members of early communities being cared for, usually by woman, we can see that, the nurse as saintly domestic is no modern invention (Kampen, 1988,p. 36). The earliest Greco- Roman depictions were almost entirely of baby nurses and the image of the modern nurses tender of the sick or wounded was not to appear until the fourteenth century (Kampen, 1988, p. 16). With the emergence of religious orders and associated charitable services came a new iconography of nursing which showed women extending their care practices from the immediate house-hold and family arena to the care of strangers. The stereotypical view of nurses as working only in acute care, high technology areas often portrayed in the media makes it very difficult to provide the alternative view of nurses working within the community, which is more difficult to make a attention grabbing. In fact, stereotypical views of nursing have a negative impact even on nurses who practice in acute care hospitals.

NURSING STEREOTYPES:
Stereotypes of a profession are not necessarily deleterious to the profession in question. Physicians, for example, are considered to be the major players on the health care stage and are viewed as totally responsible for all the good things that happen to the patient, when in fact, it may be the nurse, nurses aid, or another clinician who was also responsible for an excellent outcome. If the sole problem with nursing stereotypes was just that some get- well cards, tabloid newspaper stories, or X- rated films portrayed nurses as over sexualized bimbos, then perhaps we could laugh it off, but when the effects of stereotyping are more serious, then there is more at stake than nursings collective need to lighten up. The problem for nursing is that its major stereotypes are so unrelentingly negative in their connotations and so wholly untenable in their

relationship to the reality of nursing. The nursing and perceptions of nursing, both within the profession and in society in general, are important for several reasons. We live in an era where image and the marketing of image has never been more important .While nurses can certainly maintain that the core business of nursing is caring for the sick and assuring the health and wellbeing of the people, and nurses would be foolish to ignore the importance of nursings image .If the public does not understand the breadth and complexity of nursing work, it cannot fight for the social and financial resources that allow nurses to do that work.

NURSING STEROTYPES:
Nurses need to define the scope of their own profession Kalisch and Kalisch identify following images of nursing: Angel of Mercy- self- sacrificing, moral, noble Girl Friday- Subservient, physician handmaiden Heroine- Brave, dedicated Wife/Mother- Maternal, passive, domestic Sex object- Sensual, romantic, promiscuous Careerist- Knowledgeable, intelligent, respected professional Bureaucratic- Does anything necessary, emphasis on structure Battle Ax- bossy, scary, inflicts pain and humiliates into compliance and another long standing Image that is not often acknowledge Technology expert- operates, problem solves machinery and equipment; teaches and convinces patients to comply with positioning, acceptance, etc. Perhaps the biggest stereotype is Nurses are WOMEN

WHAT INFLUENCES NEGATIVE STEREOTYPES?

advertisements television programs internet movies music videos society

DO YOU THINK WHETHER MEDIAS ARE INTENSIFYING YOUR IMAGE IN PUBLIC?

Many of the immediate causes of the nursing crisis have their roots in undervaluation of the profession, which is driven by stereotypes. As the reactions to recent problems show, many people still have no idea that nurses are autonomous professionals with advanced skills. Instead,

much of the public continues to believe that the profession is defined by one- dimensional feminine extremes, from the handmaiden to the angel to the harlot. Some of these images have been present in one way or another since Florence Nightingale and other reformers founded the modern nursing profession in the 19th century. But today, the mass media plays a key role in forming and reinforcing these popular attitudes. Indeed, research confirms that even television dramas affect the publics view and decisions about health care. In a 2008 study, nursing scholars at Dundee University found that television images of nurse as brainless, sex mad bimbos were discouraging academically advanced primary school students from pursuing the profession. The news media often ignores nurses real contributions to modern health care. Usually, elite press entities consult only physicians as health experts. People still consider nurses second class, thinking they are not as smart as doctors or not willing to put in the time doctors do. Newspapers are trying to create an image of sympathy on nursing profession, but unfortunately nursing fraternity do not like this. These are also demolish the public image of nurses. Famous writers were also use nurses as emotionless creatures in their work. During the 19th century, two opposing images of nurses were identified. Florence Nightingale represented a symbol of excellence and gave the nursing profession acceptance and public respect. But Sairy Gamp, a midwife created by Charles Dickens in Martin Chuzzlewit, was depicted as old, fat , rough and unsightly- in Dickens words, unclean, uneducated, untrained and unreliable. Linda Lark and Susan Barton were the famous books in the adult literature category but they given a nymphomaniac image to the nurses. Even though nurses are the vital part in the health care industry and public health, but the public health medias consider nurses as useless brains. Majority of the movies trying to highlight the stereotypic characters of the nurses, in One Flew Over the Cuckoos Nest, a 1970 movie, nurse Ratchet was shown to be evil by exerting power over doctors as well as her patients in the mental institution. This nurse had no redeeming qualities and was devastatingly cruel. Cartoons are also trying to draw nurses as house maids, attender and other naughty characters. Advertisement tries to maintain the professional integrity but there are also some dragons to catch the truthful image of nurses. So many nursing groups are available in internet but some hackers are trying to defame the nursing community.

THE TRUTH NEVER DIES

The mass media is in the business of attracting viewers and affecting how and what people think. To believe that people are able to disregard everything they perceive in the entertainment media because the scenarios presented are not literally true, or because they are loosely staged simulations of reality, would have us believe that people disregard all messages in advertising. That is not how the human mind works. Medias are eager to cover only the issues and problems of the profession, unfortunately they are not interested to transmit achievements of nursing profession.

Programmes of other professions get more media coverage, so they can improve their image in the public. Mass-medias give prime importance to the celebration of certain professional days, but they dont know about the international nurses day. Less coverage to the scholastic achievements of the nurses Nurses also had representation in the public health medias but the number is negligible compared with other allied health professions Even the nurses are the achievers of Padmasree awards , but medias close their eyes towards that achievements Although there are many reasons why the nursing profession is facing a crisis, one of the major reasons shortages exist in the nursing ranks is that the nurse has a poor image. In todays world of multiple media sources there are real problems affecting the nursing profession. Nursing is symbolically annihilated by the mass media and virtually ignored Nurses and others earn doctoral degrees and make contributions to health and society that are just as valuable as contributions made by the physicians. So the honorific should be available to everyone with that degree or to no one To perform their jobs , nurses have to be good communications, but they dont tell their own stories because they are afraid of breaching confidentiality. They could talk about their work in general terms, but using specific details to express the difficulty and tragedy they face daily Various countrys governmental systems were honored the nurses through their postal stamps

HOW NURSES CAN UPLIFT THEIR IMAGE IN PUBLIC MEDIAS?

Gaining Legitimacy and Presence in the Media Nursing curriculum and continuing education need to acknowledge the need for courses in the legislative process and media relations Nurses need to believe that they have something relevant to say and that people should stop and listen including the media. Running down the hallway to catch a doctor for an order is a two-edged sword If nurses meet journalists, they should offer their services as health care experts Nurses must be proactive. Nurses must encourage their institutions to send press releases about nursing research findings to the local or national media Nurses need to know how to write for the media. Nurses should be encouraged to write editorials, commentaries and letter to the editor Nurses must debunk myths and communicate how health care and nursing issues affect the larger population and health care system The media must be aware of the different specialties in nursing and advanced nursing abilities.

 Nurses need to respond to articles in the media and the absence of nurses in the article by writing a letter to the editor and communicating how nurses have had an impact on this subject, research being done by nurses, and how nurses are specialist in this area. Communicating to the public Raise the voice campaign against defaming characterizations in social medias. Be honest and ethical in their profession. Being a professional for 24 hours for all the days. Be assertive Posting, circulating, and advertising nursings accomplishments. Using the local community newspapers for ongoing announcements. Having staff contribute to the community by writing health- related articles in the newspaper. Government leaders and other policy makers should publicize their efforts to invest in nurses practice, education, research, and residencies, and place qualified nurses in visible positions of authority. Creation of Nobel Prize in nursing to recognize nurses whose work has changed the world and initiate effort to start an international museum on modern nursing.

CONCLUSION- FROM AFFRONT TO ACTION:

What can individual nurses do to influence the image of nursing? It is often easy to assume that professional issues, such as the image of nursing, are only the concern of the profession as a whole. However, many nursing isssues require individual nurses to take action in response. The image of nursing is certainly influenced by broad concerns, such as content in television, film, or advertising. But much of the image of nursing comes from the day to day personal contact that the public has with nurses and that the nurse has with other health care professionals in the workplace. During the past two decades, there has been a plethora of research and discussion regarding nursings image and the portrayals of nursing. We are now much aware of the forces that shape and maintain many of popular cultures images of nurses and nursing. Perhaps the next two decades will see nurses moving from a position of greater awareness to one of more positive action. By this we mean that nurses will move beyond their outrage at the negative stereotypes that they encounter, that they will talk more with the media and the political community- as well as friends, neighbors, and family members- and that they will encourage their hospitals to promote their work. THE MEDIA IS THE MOST POWERFUL ENTITY ON EARTH. THEY HAVE THE POWER TO MAKE THE INNOCENT GUILTY AND TO MAKE THE GUILTY INNOCENT, AND THAT IS POWER. BECAUSE THEY CONTROL THE MINDS OF MASSES. (MALCOM X, 1960)